May 8, 1991, I counted backwards from 100: 99, 98, 97 and the voices went quiet. I lay unconscious, a tube down my throat. A man cut an incision under and into my nose, separated skin and cartilage from my skull and peeled my face open to break and scrape and slice and squeeze the stuff inside. I picture blood pooling in my exposed sinus cavities. Bone and tissue in a steel bowl. I remember waking up sewn back together, my head wrapped in plaster, my sinuses stuffed with gauze but not enough to keep the blood from pouring down over my lips, my chin, dripping onto my white hospital sheets.

I called out for help, and a nurse shoved some more gauze at me.

I told my mother, “I can’t believe I did this to myself,” when she came to get me. I wasn’t quite crying, because to cry would require distortions my mallet-bashed face couldn’t manage. I was dressed by then, sitting in a wheelchair, my bandages and plaid shirt rust-stained.

I was turning 15 in a couple of weeks, and this was my birthday present, from my parents and my grandmother. Rhinoplasty—a nose job. No more serious than getting my tonsils out. And now my life would be better.

My 12-year-old sister couldn’t look at me for two weeks. I couldn’t talk or chew without straining the stitches between my nostrils. Laughing was torture. I had to breathe through my mouth, my sinuses swollen and jam-packed with cotton. According to my father, I wouldn’t let anyone turn on my bedroom light, because I didn’t want to be seen all bandaged and bloody.

I finally returned to the doctor to have myself unwrapped and unstuffed. He held up a mirror, warning me my lip and nose were swollen and my eyes bruised. In that mirror I saw someone who resembled me, like a close relative: I would never see my real face again.

— — — — — — — —

About a year ago, when I was 37, I demanded of my parents—as they stared at me in bafflement over a restaurant table—how they could have let me go through with such a painful and misguided procedure. I regretted it, missed my old nose with its large dorsal hump and prominent over-projected tip. Wished I’d had the wherewithal to notice the racism inherent to my youthful self-loathing. Why hadn’t they done their research? They could have read Sander Gilman’s book, The Jew’s Body, or at least the chapter about Jewish noses, in which he explains that a nose like my old one makes the stigmatized Jew feel painfully visible, insofar as “visibility means being seen not as an individual but as an Other, one of the ‘ugly’ race.” I informed my parents, moreover, that they should have realized I needed therapy, not a nose job, to address my self-esteem issues.

So when I call now and ask them, more calmly, how I ended up getting a nose job at 14, my father’s more than a little on guard. But my mother starts talking, and he’s swept up in the conversation.

They both recall that the surgery was initially my idea, an idea that preoccupied me. Apparently I blamed my nose for all my (significant) social failings. And then, Mum says, I mentioned the nose-job plan to my Nana—my paternal grandmother. “She thought it was a good idea, so she encouraged you, and she encouraged Dad and me as well. I guess because, in her circle, it wasn’t a big deal, sort of like having your tonsils out.”

“And what did you think?” I ask my father.

He answers slowly and carefully. “I thought I wanted you to have what you wanted. And you felt it would make you—I mean you really—you really wanted it badly. And the surgeon said it was normal and safe.” He adds, “You were more than adamant. It was a passion.”

We’d moved from near Washington, D.C. to Ottawa when I was seven, and none of my classmates had refurbished noses; I don’t know where I would have come up with the idea. My best friend recalls me telling her, at the time, that the surgery was my grandmother’s idea. But if Nana was a driving force behind my surgery, she doesn’t remember it. I ask how I decided to have the surgery, and she hesitates. “I think you didn’t like your nose.”

I do remember how, at 11, 12, 13, I felt deeply unpretty—and prettiness seemed merely an absence of offending features, the way cleanliness is simply an absence of dirt. I wanted to look like the popular girls, with their smooth pale hair and even, average features. I longed to be inconspicuous, invisible. However, oddly enough, it did not occur to me that I looked Jewish—or even, really, that I was Jewish. My father is Jewish and my mother’s father was Jewish. According to Jewish law, legitimate membership in the tribe requires matrilineal descent, and I was raised in a secular household. So I have three Jewish grandparents, but culturally and technically, I am not Jewish at all; and as a young teenager, I thought of myself, if I thought in terms of race at all, as a white British-Canadian girl. I certainly didn’t know that my not-so-distant ancestors in Eastern and Western Europe had not been considered white in their day, had barely been considered human.

I am not claiming that all my childhood difficulties arose from my confused and confusing ancestry, or even from the relatively recent European history that severed and incinerated whole limbs of my family tree. I only have to wonder: Was I depressive and anxious by genetic design or neurotic as a descendent of Holocaust survivors or just a difficult child? Was I socially isolated, on some level, because I looked ethnic, immigranty, Jewish, or did I suffer from some kind of body dismorphia? Or did I really just have an ugly face—a contingency that would make any childhood difficult?

— — — — — — — —

My mother grew up in London, England, with a lapsed-Anglican mother and Atheist Jewish-by-birth father, and doesn’t recall anyone she knew getting a nose job or talking about it. She says the concept of cosmetic surgery was new to her when she moved to the U.S. with my dad in 1979. My father and aunt, Rachael (not her real name), began their lives in London, too. They lived in a Jewish family in a Jewish neighbourhood, and left for America when my father was 11 and Rachael 15—she turned 16 two days before their ship arrived in New York, in 1960. When they began school in Silver Spring, Maryland, Rachael says, she was acutely culture shocked: the girls in her Grade 11 classes had braces and their own cars. Meanwhile, my grandparents didn’t even have a car. Both my father and Auntie Rachael have talked about feeling ostracized—feeling like “refugees”—due to poverty, due to their unstraightened teeth.

My father, who graduated from his American high school in 1968, says that nose jobs were “very common.” When I ask him to describe the demographic that underwent such surgery, he identifies white girls. Then adds, “My impression, thinking back, is that they were Jewish kids, but I don’t know that for a fact.”

Auntie Rachael, however, tells me that rhinoplasty was the realm of 16-year-old Jewish girls, and, judging by the experiences of her acquaintances’ grandchildren, still is. “In these rich—not rich—but—Jewish families, having a nose job is like a coming of age. If you need it.”

But how do you know if you need it?

Well, if you have a bad nose.

And why Jewish girls, in particular?

“They were the ones with the bad noses,” says Auntie Rachael.

What’s a bad nose?

Anything bigger and bumpier than “a tiny little triangle,” Rachael says, is less than ideal. Some people are born with those perfect noses, she adds, and names her (Anglo-Saxon) daughter-in-law.

Rachael, my grandmother tells me, “needed her nose done, too, when she was 16 or 17, but she wouldn’t do it.”

“I always thought I had a hateful nose,” Rachael agrees. “But when I had an opportunity to do it, I was too scared.” (I tell her that I love her nose the way it is. Truthfully, I’ve always found Auntie Rachael’s face exceptionally appealing. She doesn’t seem to hear me.)

My grandfather, now long deceased, was a tailor, and after immigrating opened his own shop. My grandmother got a job selling clothes in a high-end clothing store, and from there worked her way up, up and up; when I was a child in Maryland, she managed a whole department store and was considered an haute couture expert, hobnobbing with internationally famous fashion designers and catering to some of the wealthiest women in the country.

She never knew about nose jobs in England, Nana tells me, but working as she did with D.C.’s elite in the ’60s, she saw mothers taking their daughters for schnoz upgrades as soon as the girls turned 16. “Nobody thought it was a big deal.” She denies that rhinoplasty was or is a particularly Jewish phenomenon, however: “It’s everybody.” Nana says that she is “absolutely” a proponent of cosmetic surgery. If looking better makes you feel better, and you can do it, why not?

Rachael corroborates that my grandmother “believes you should do anything you can to improve how you look”—that beauty, or a close approximation, is vital for success, socially and in business. I ask Rachael what she thinks about that, and she says, without hesitation, “I think it’s true.”

Nana, it must be said, was and is an extraordinarily stunning, articulate and charismatic woman. She achieved monumentally more, career-wise, than a female, eastern-European Jewish immigrant with no formal education could ever have hoped, certainly only aided by her “movie-star type looks,” as Rachael puts it, “and this glam and outgoing personality.” Nana knows intimately (though she will never admit it) the privileges bestowed on the beautiful.

— — — — — — — —

Full disclosure: I considered a second surgery. Something likely went wrong the first time, causing the excessive bleeding and pain I suffered, and my nose healed imperfectly. Too much bone was removed from the bridge, leaving it a little flat, as well as crooked. The cartilage in the tip is full of scar tissue, leaving me with a “polly-beak deformity,” according to Calgary’s Dr. Kristina Zakhary, who recently took my nose between her fingers and gently wiggled it around.

As my Nana puts it, “You could have done with a bit more off.” So I almost got a second nose job when I was 22; I had a consultation with a surgeon who told me I’d started down nose-job road due to a classic “ethnic problem.” Somehow, until then, my bio-nose’s status as ethnic calling-card had not occurred to me. The implications came as a shock, and dissuaded me from going through with another adjustment.

When Auntie Rachael asks why I’m writing about rhinoplasty—what I’m getting at—I say I’m not sure, but add that nose jobs were invented by Jews, for Jews, that the first contemporary rhinoplasty was performed in 1888 by German-Jewish surgeon Jacques Joseph (nee Jacob Joseph), to cure a hefty-nosed patient of the melancholy arising from social exclusion and ridicule. In 1933, one patient reported that “Nosef,” as the surgeon became known in the German-Jewish community, sometimes provided his service for free “when he felt that someone suffered from a Jewish nose” but couldn’t afford the surgery.

Was simply looking too Jewish the issue, attractiveness aside?

“Look at the propaganda and all of that,” Rachael agrees. “It was really prevalent. All of the caricatures…”

In The Jewish Body, Melvin Konner includes an 1888 chart entitled “How We May Know Him,” designed to help the unsuspecting spot sneaky Semites. The labelled illustrations include “Ill-shapen ears of great size like those of a bat,” and of course, “Curved nose and nostrils.” As Gilman writes, the Jewish nose’s “nostrility” was at one point even believed a result of congenital syphilis. In any case, the Jewish nose was considered to embody a combination of racially inscribed characteristics which set Jews aside as an entirely different species—a dangerous combination of craftiness, avarice and amorality. All this is summed up rather neatly in the following joke: Why do Jews have big noses? Because air is free.

“I’m sure that was part of it,” Rachael muses. “The parents wanted their girls—their kids—to have a life without being made fun of, being called big-nose, hook-nose, Jew-nose. And in the ’60s it was only 20 years after the war.”

The war—the Second World War—is, of course, the elephant in the room. In 1933 Berlin, as Nosef performed his free rhinoplasties, looking Jewish was more than a minor social liability; it would soon become a matter of life and death. As Konner describes, in the Nazi era, German children were taught how to spot Jews attempting to “pass.” And in the 1930s, Berlin was exactly where my Nana and her parents lived. They eventually escaped to England, leaving their home and all their belongings in the middle of the night. Many of their relatives and friends died at the hands of the Nazis.

And as my aunt intuited, rhinoplasty’s popularity among North American Jews peaked in the ’60s and ’70s. Though no such studies have been conducted in Canada, recent statistics from the American Society of Plastic Surgeons reveal a 37 percent decline in nose jobs between 2000 and 2011. Moreover, the procedure’s increased popularity among Asian and Hispanic communities implies that Jews are getting even fewer nose jobs than the numbers show. Melvin Konner told Tablet magazine in 2012 that the explanation likely lies in Jews becoming more proud of their heritage, and less anxious to assimilate.

— — — — — — — —

“Is it ethnicity or is it esthetics?” Auntie Rachael muses, at the end of our chat.

In pursuit of answers, I visit Calgary cosmetic surgeon Dr. Greg Waslen in his office. As he sits down across from me, I get the distinct impression he’s sizing up my features. I feel like he knows my secret: that, though I’m here as a journalist, I had a “bad nose job” as my Nana once called it.

I decide to clear the air, and tell him that I was inspired to write this story because of my own experience. He nods. “You had a very basic rhinoplasty that I wouldn’t do, because it’s not sophisticated,” he says. He tells me my surgeon just took the “hump” off, flattening the bridge, “which doesn’t make it attractive.” And, he adds, they didn’t do enough to the tip, so my face is unbalanced. He takes out a calipre and proceeds to measure my face, explaining that in the golden ratio—1:1.618—lies the empirically demonstrated source of beauty, in everything from flowers to faces. My face, he shows me, is well proportioned, except for my nose, which is out of whack in several regards.

Waslen denies any correlation between ethnicity and nose shape or relative beauty, though. It’s just about math—design. He shows me on his computer how I’d appear with my profile adjusted for perfection, ratio-wise. “Looks cuter,” he says. Then he makes my nose bigger and hookier, to show me what I’d probably look like if I’d never had surgery in the first place. “More severe,” he says. He’s right, on both counts.

Dr. Kristina Zakhary, across town, is a head-and-neck surgeon with a specialty in facial plastic surgery. She agrees that the golden ratio is a useful ideal, but adds, “The truth is that the outcome of the surgery depends on more than just numbers and angles. It depends on the gender of the patient, the skin pigment of the patient, the ethnic background of the patient, and how the patient heals.” Ethnic background, because some races tend to have thicker skin or to heal better than others. Rhinoplasty is really more of an art than a science, she says.

Zakhary, who is Egyptian, and has undergone rhinoplasty herself, most assuredly still looks Egyptian. And stunning. “One hundred percent of the patients I operate on want to maintain their ethnic characteristics,” she says.

“The pursuit of beauty—and the pursuit of, say, rhinoplasty—is ingrained and hardwired in our genes, because it’s something called koinaphilia, based on the Darwinian theory of evolution and survival of the fittest.” She explains that humans, and other animals, choose mates of average looks. “The extremes are selected against.” But the average face is no longer white and WASPy. The prevalence of immigration in North America means we’re constantly exposed to different features, and our beauty standards are constantly changing. “The idea that ethnic patients want a more Caucasian nose is an archaic idea and not compatible with the changing perception of beauty over time,” Zakhary tells me.

I think of the “cuter” nose on Waslen’s digitized other-me. And I think of the me he showed me from the universe where I never had surgery at 14. I ask Zakhary if a different nose really makes a difference to a person’s life.

“A huge difference,” she says. If a person has “reduced self-esteem and self-image—if in fact it’s their nose that’s caused all that—then changing their nose will radically improve their self-esteem.” Plus, she says, “more attractive people get better jobs, better pay.”

The truth is, my life did change after surgery. The new nose may not have been perfect, may not have transformed me into a great beauty, but I felt light—I felt less visible, and at the same time more appealing. I could look people in the eye without feeling the presence of some shameful misshapen something between us.

— — — — — — — —

In 1850, Scottish zoologist Robert Knox described the Jewish nose as “a large, massive, club-shaped, hooked nose, three or four times larger than suits the face… thus it is that the Jewish face never can [be], and never is, perfectly beautiful.”

One afternoon, in high school, a Jewish girl with a locker near mine told me her mother had undergone a nose job in her youth. “And it’s a good thing,” the girl said, “because my dad says he never would have married her otherwise.”

Not such an uncommon sentiment: today, Dr. Michael Salzhauer, an Orthodox plastic surgeon in Miami, offers free rhinoplasty to Orthodox Jewish women referred by a matchmaker or rabbi. Though cosmetic surgery may seem to violate Jewish law—created b’tzelem Elokim, in the image of God, we are prohibited from esthetically modifying our bodies—rhinoplasty is allowed if deemed necessary for the patient’s psychological health, or for the patient to attract a husband.

I’d like to think that even with my original schnoz, I could have thrived. But part of me wonders, of course, whether it’s true, whether without a fix-up I would have made friends, established a career, attracted partners or lovers. Easy enough to say I regret the surgery when I haven’t seen my first face in two-and-a-half decades, and can’t remember just how gargantuan my nose used to be. For some reason, I have few photographs of myself between the ages of about 12 and 15.

“You didn’t have a big nose,” my mother insists. “There was a bit of a bump.”

“I remember you had a large bump on your nose,” my dad adds.

“Did my nose look like other people’s in the family?” I ask.

“No,” says my dad.

“What do you mean?” my mother asks him. “She had your nose.” A pause. Nervous laughter. “No—Naomi, you had a normal nose with a little bump.”

“And that was the issue,” says my dad.

I ask what they thought about the outcome of my surgery. My mother is silent. My father tells me, after a long pause, that I look lovely and looked equally lovely before.

What bothered them, they both say, was my painful recovery from the operation, a far cry from the “no big deal” the doctor had promised.

A bump? So I never even had a disproportionate face? A “severe” profile? A Jew-nose worthy of free-air jokes? Would it truly have made no difference at all, if I’d never gone under that knife?

And if I had my father’s nose, that invites the obvious question: Why did no one ever suggest my father have his own nose slimmed down? Why are only girls and women held to beauty standards for which we are literally willing to risk our lives? According to Nana, plenty of men undergo cosmetic surgery of all kinds; they just don’t talk about it. But certainly far more Jewish women than men have cut off their noses to spite their race, to steal a quip from Dorothy Parker. Which is ironic, considering that the European 19th-century warnings about Jews, with their big noses, feeble bodies and bags of money, referred to men, exclusively. Jewish women (“Jewesses”) were barely mentioned, or noticed.

— — — — — — — —

A few minutes after I finish force-interviewing my parents, my father calls back. Says he’s been thinking it over, and wants to make sure he’s been completely honest. “The bump or whatever did make your nose look disproportionately large for your face,” he says. “And I remember in that sense understanding where you were coming from. It didn’t detract from your good looks—it was part of you. But it’s not like I thought you were making something up.”

Naomi K. Lewis is a fiction and non-fiction writer, editor and teacher who lives in Calgary.

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